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Research on technology evaluations

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 you are here › HomeFunding OpportunitiesResearch on technology evaluations

The technology evaluation theme covers evaluations into the efficacy, effectiveness, costs and broader impact of healthcare interventions. Technology evaluations are funded by the:

Would my primary research idea be of interest to the EME programme or the HTA programme?

Download a pdf of this page (Characteristics of the EME and HTA programmes)

EME Research

The EME programme commissions research that is designed to advance scientific knowledge. EME research is undertaken earlier in the development pathway than HTA research and is undertaken when there is some initial evidence that the technology is efficacious in patients (where proof of concept in humans has already been achieved) but a study is needed to determine definitive proof of clinical efficacy, size of effect, safety and possibly effectiveness. An intervention which is being tested for efficacy must be clearly present in all evaluations, other than diagnostic evaluations.

HTA Research

The HTA programme commissions research that is immediately useful to clinical practice and policy/decision makers. HTA research is undertaken when there is reason to think the technology is efficacious but there is uncertainty around its clinical and cost effectiveness in a real life NHS setting in comparison to the current best alternative(s). There may also be uncertainty around its place in the existing care pathway.

Table comparing typical characteristics of HTA and EME research:

Characteristic EME HTA

Evaluates

Efficacy, safety and possibly effectiveness of a medical intervention under ideal conditions

Effectiveness of a medical intervention in a real life NHS setting

Types of research

Primary (clinical research)

Usually exploratory research with expert care

Primary (clinical research)

Secondary (evidence synthesis, e.g. a systematic review or meta analysis)

Usually pragmatic research with routine care

Stages of research

EME would consider research which has already been successful in the first stages of testing in humans (often volunteers), and where the required intensity/level/dose of an intervention has been decided

EME research would be specifically designed to evaluate efficacy and whether the treatment works under ideal conditions, and may gather further information on safety

HTA research would normally follow that which is suited to the EME programme, however there is some overlap with the later stages of EME research

The main focus of HTA research is long-term effectiveness and the impact on patients’ quality of life as well as cost effectiveness.  These studies would evaluate effectiveness in a real-world NHS setting

Design

A clinical trial or evaluative study (not necessarily an RCT). May also include laboratory based, or similar studies that are embedded within the main EME study

Often a pragmatic randomised controlled trial although other study designs may be used for instance in the evaluation of diagnostic tests

Participant eligibility criteria

More stringent and not necessarily representative of the UK population

Wide and representative of the UK population and reflects the mix of patients likely to be seen in normal clinical practice

No. of participants & centres

Small to Large - may be single or multi-centre

Generally large – adequate to assess minimally important differences from a patient perspective; usually multi-centre generating results that are generalisable to the NHS

Technology*

Mostly developed and defined but some refinement / fine tuning may still be needed

Fully defined and developed technology

Comparator

Likely to be placebo but could be usual care or the best active alternative

The best active alternative or usual care. Placebos may be used in conjunction with best treatment to blind trial participants

Outcomes

Validated surrogate markers as indicators of health outcome are acceptable

Clinically important outcomes that matter to patients and that measure health gain

Follow up

Sufficient for the outcome to be manifest.  When surrogate outcomes are used, for example, this may be shorter than in typical HTA research

Sufficient to ensure that a wider range of effects are identified other than those which are evident immediately after treatment

Health economic component included?

Not usually

Usually cost-utility or cost effectiveness

Can a mechanistic evaluation be included as part of the main study?

Yes.  Evaluations which help to understand how an intervention works, or how behaviour affects or is affected by an intervention, may be included as part of the main EME study

Not usually, it would only be a secondary consideration to assessing cost-effectiveness

Diagnostic evaluations

Likely to support validation of a diagnostic test

Unlikely to include evaluations which seek to determine the effects of introducing a new diagnostic test into clinical practice

Unlikely to support evaluations which seek to determine the normal range of values for a diagnostic test through observational studies in healthy people

Likely to support the evaluation of cost effectiveness in routine clinical practice

 

*By “technology” we mean any method used to promote health, prevent and treat disease and improve rehabilitation or long-term care. “Technologies” in this context are not confined to new drugs but include procedures, devices, tests, settings of care, screening programmes and any intervention used in the treatment, prevention or diagnosis of disease.

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The NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC), based at the University of Southampton, manages evaluation research programmes and activities for the NIHR.

 

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